JEREMY ROBERT ANCLAM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

ACTIVE

Business

Title

First Name

JEREMY

Middle

ROBERT

Last Name

ANCLAM

Business Name

JEREMY ROBERT ANCLAM DO

Original Issue Date

07/22/2022

Effective Date

07/28/2023

Expiration Date

07/31/2026

City

FREEPORT

State

Zip

61032

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/28/2023